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NPI Code Detail

MEDICARE: DR. RUTH GENTRY PHD

MEDICARE: DR. RUTH GENTRY PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist0659NV

General Provider Information

NPI Number : 1407122724
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RUTH GENTRY PHD
Provider Business Mailing Address
First Line : 10631 PROFESSIONAL CIR STE A
Second Line :
City : RENO
State : NV
Zip : 89521-5835
Country : US
Telephone Number : 775-830-8375
Fax Number :
Provider Business Practice Location Address
First Line : 10631 PROFESSIONAL CIR STE A
Second Line :
City : RENO
State : NV
Zip : 89521-5835
Country : US
Telephone Number : 775-830-8375
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2012
Last Update Date : 06/19/2013

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